摘要
目的探讨妊娠期糖尿病(GDM)患者血清25羟维生素D[25(OH)D]、铁蛋白(SF)及糖化血红蛋白(HbA1c)水平检测及临床意义。方法选择2021年1月至2023年7月在郑州市妇幼保健院产检的60例GDM患者设为GDM组,60名健康产妇并设为对照组,采集入组对象空腹状态下5 ml肘正中静脉血,离心取上清液,使用电化学发光免疫分析(ECLIA)测定SF、25(OH)D,使用胶乳增强免疫比浊法测定HbA1c。对比2组孕妇SF、25(OH)D、HbA1c检测值差异,Logistic回归分析显示,三者与GDM发病的关系,并绘制受试者工作特征(ROC)曲线,分析SF、25(OH)D、HbA1c联合检测诊断GDM的价值。结果GDM组SF、HbA1c检测值高于对照组,25(OH)D检测值较对照组低(P<0.05);Logistic回归分析显示,SF(β值=2.559,OR值(95%CI)=12.923(3.665,45.571)、25(OH)D(β值=-0.022,OR值(95%CI)=-3.667(-5.967,0.990)、HbA1c(β值=1.128,OR值(95%CI)=4.355(1.860,5.133)均是GDM发病的高危因素(P<0.05);SF诊断GDM的曲线下面积(AUC)为0.747(渐近95%CI):(0.659,0.838),灵敏度为0.750,特异度为0.717,约登指数为0.467;25(OH)D诊断GDM的AUC为0.728(渐近95%CI)=(0.637,0.820),灵敏度为0.717,特异度为0.633,约登指数为0.350;HbA1c诊断GDM的AUC为0.780(渐近95%CI):(0.697,0.863),灵敏度为0.800,特异度为0.767,约登指数为0.567,SF、25(OH)D、HbA1c联合检测诊断GDM的AUC为0.855(渐近95%CI):(0.786,0.924),灵敏度为0.883,特异度为0.783,约登指数为0.666,均高于各指标单一检测。结论GDM患者血清SF、25(OH)D、HbA1c水平异常,三者均与GDM发病有关,联合检测可为提高GDM检出率。
Objective To explore the detection and clinical significance of serum 25 hydroxyvitamin D[25(OH)D],ferritin(SF)and glycosylated hemoglobin(HbA1c)levels in patients with gestational diabetes(GDM).Methods Sixty GDM patients who underwent prenatal examination at Zhengzhou Maternal and Child Health Hospital from January 2021 to July 2023 were selected as the GDM group,and 60 healthy postpartum women were selected as the control group.5 ml of cubital veinblood was collected from the group subjects under fasting state,and the supernatant was centrifuged.SF and 25(OH)D were measured using electrochemical luminescence immunoassay(ECLIA),and HbA1c was measured using latex enhanced immunoturbidimetry.Comparing the differences in the detection values of SF,25(OH)D,and HbA1c between two groups of pregnant women,logistic regression analysis showed the relationship between the three and the onset of GDM,and the receiver operating characteristic(ROC)curve was plotted to analyze the value of combined detection of SF,25(OH)D,and HbA1c in the diagnosis of GDM.The results showed that the detection values of SF and HbA1c in the GDM group were higher than those in the control group,while the detection values of 25(OH)D were lower than those in the control group(P<0.05);Logistic regression analysis showed that SF(βvalue=2.559,OR(95%CI)=12.923(3.665,45.571),25(OH)D(βvalue=-0.022,OR(95%CI)=-3.667(-5.967,0.990),HbA1c(βvalue=1.128,OR(95%CI)=4.355(1.860,5.133)are all high-risk factors for the onset of GDM(P<0.05).The area under the curve(AUC)for SF diagnosis of GDM is 0.747[asymptotic 95%CI:(0.659,0.838)],sensitivity is 0.750,specificity is 0.717,and Jordan index is 0.467;The AUC for diagnosing GDM with 25(OH)D is 0.728[asymptotic 95%CI:(0.637,0.820)],sensitivity is 0.717,specificity is 0.633,and Jordan index is 0.350;The AUC of HbA1c in diagnosing GDM is 0.780[asymptotic 95%CI:(0.697,0.863)],sensitivity is 0.800,specificity is 0.767,Jordan index is 0.567,and the AUC of SF,25(OH)D,and HbA1c combined detection in diagnosing GDM is 0.855(asymptotic 95%CI:(0.786,0.924)],sensitivity is 0.883,specificity is 0.783,and Jordan index is 0.666,all of which are higher than single detection of each indicator.Conclusion The abnormal levels of serum SF,25(OH)D,and HbA1c in GDM patients are all related to the onset of GDM.Combined detection can improve the detection rate of GDM.
作者
吴文娟
Wu Wenjuan(Department of Laboratory,Zhengzhou Maternal and Child Health Hospital,Zhengzhou 450012,China)
出处
《实用医技杂志》
2024年第2期124-127,共4页
Journal of Practical Medical Techniques
